Skip to main content

Full text of "Stanford University Medical Center, 25 years"

See other formats


tanford University Medical Cente 







25 YEARS OF DISCOVERY 



September 1984 marked the 25th Anniver- 
sary of the relocation of the clinical pro- 
grams of the medical school to the Stan- 
ford campus after 51 years of existence in 
San Francisco. The event provides a suitable op- 
portunity to express our deep appreciation to 
the university trustees and administration, the 
faculty, staff and students, and the many 
friends whose collective support and encour- 
agement over the years have made the school 
and the Stanford University Medical Center 
possible. 

As the articles on these pages show, the past 
25 years have been truly years of achievement in 
science, clinical medicine and medical educa- 
tion. The school has led the way in providing an 
education that traditionally and consistently has 
been excellent. This tradition has been chal- 
lenged throughout the years by changes in soci- 
ety and in the medical profession itself, as well 
as the school's geographic location, physical fa- 
cilities, aolministrative policies, curriculum and, 
of course, faculty and students. Like all medical 
schools that are a part of large academic medical 
centers, Stanford faces new challenges brought 
about by pressures on society. Some of the is- 
sues include the increasing scarcity of funds 
available to support medical education, govern- 
ment regulation and trends revising the way 
medical services are delivered to the public and 
paid for. 

But I am certain that both the school and the 
medical center will rise to the challenges as long 
as they remain part of the university and are 
dedicated to their fundamental missions of 
discovery, dissemination of knowledge and 



the education of future generations of pro- 
fessionals, scholars and citizens. 

When the medical center was dedicated 
in 1959, it was based on these principles 
summarized below: 

'To bring together under one roof a full 
time faculty in the basic and clinical sciences 
to advance medical knowledge. 

"That the future progress of the medical sci- 
ences is inextricably linked with progress in so- 
cial sciences as well as biological sciences and 
that opportunities for enrichment would be 
enhanced by integrating medicine with the 
university. 

'To develop a new program of education that 
provides medical students with sufficient time 
and opportunity to carry out scholarly research 
programs outside of the usual medical school 
classes. 

"To provide the opportunity to apply discov- 
eries from the laboratory to clinical care. 

"To provide examplary patient care in a teach- 
ing hospital environment both to the citizens of 
Palo Alto and nearby communities and to those 
patients referred for specialized care." 

The object of the Anniversary celebration is 
to rededicate the Stanford University Medical 
Center to these principles. 




Lawrence G. Crowley, M.D. 

Vice President for Medical Affairs 

& President, Stanford University Hospital 




A NOVEL CURRICULUM 
AT CENTER STAGE 



by Spyros Andreopoulos 



/n important event associated with the formal ded- 
i ication of the Stanford University Medical Cen- 
V ter was the address delivered on September 17, 
JL 1959, by Frank Stanton, then president of the 
Columbia Broadcasting System. 

The address was given under rather difficult circum- 
stances. An unexpected rainstorm blew in from the 
Pacific, forcing the ceremony, originally scheduled to be 
held in the open area before the spraying fountains, to 
be moved indoors. There was an audience of about 2, 000 
people, and when Stanton began to talk on "Medicine 
for a New Age" one could have heard a pin drop. At the 
end of his speech, amid the enthusiastic applause of 
the crowd, Stanton made his way to the area where 
Stanford University President J. Wallace Sterling and 
dignitaries were seated and received their warm 
congratulations . 

These were the words with which Stanton so im- 
pressed the audience in Palo Alto 25 years ago: 

"Today we face the dangerous situation that one half 
of the world does not know what the other half is up 
to.... So serious is the splintering of knowledge that 
within one discipline there may be misunderstandings 
and distortions. "The medical man of the future cannot 



do everything by himself. . . .By uniting the medical school 
with the rest of the university, knowledge in the field of 
medicine and in the related biological, physical and 
behavioral sciences will be extended, more largely inte- 
grated, and focused on our understanding of health and 
illness. 

"Here on the rim of the Pacific we are witnessing the 
beginning of a great contribution." 

What Stanton foresaw signaled the end of the aca- 
demic double life students had led ever since Stanford 
University began teaching medicine in 1909 in San 
Francisco. 

At the university campus in Palo Alto, they had learned 
anatomy, biochemistry, microbiology and physiology. 
At the Stanford Hospital on Clay and Webster Streets in 
San Francisco, they had studied pharmacology and pa- 
thology, and they did their clinical work under a faculty 
of topflight but largely part-time local physicians and 
surgeons in private practice. 

When Stanford's handsome new $27-million medical 
center complex (complete with 434-bed hospital and 
outpatient clinics) formally opened, students consid- 
ered it an unqualified blessing. They could now fulfill 
their degree requirements without commuting to an- 



III 




Edward Durell Stone's drawing (top) of how Stanford University 
Medical Center might look is contrasted with the finished Edwards 
Building (bottom). 



Medical center construction began in 1957 and was 
completed in 1959. The formative stages of the hospital's 
east wing with core building can be seen. 



other campus. But in San Francisco medical circles at 
the time, the center was an object of much concern. 

At the hub of the argument was Stanford's dean of 
the School of Medicine, pediatrician Robert Alway. At 
54, he was a hard-driving administrator whose passion- 
ate interest was to improve the school. Alway was also 
a man of tough, direct methods. When he was chosen 
as dean in 1958, medical school department chairmen 
submitted their resignations as a matter of course. Cus- 
tomarily, new deans refuse. Not Alway. 

On the theory that the old Stanford had been weak- 
ened by too much scholastic inbreeding (some depart- 
ment chairmen and faculty had simply floated to the top 
on the strength of longevity), Alway went scouting for 
new talent. He quickly recruited a dazzling array of men 
for top jobs — pediatrician Norman Kretchmer from 
Cornell, Nobel Prize winning biochemist Arthur Korn- 
berg (along with almost his entire department) from 
Washington University, Nobel Prize winning geneticist 
Joshua Lederberg from the University of Wisconsin, 
immunologist Halsted Holman from Rockefeller Uni- 
versity, hand surgeon Robert Chase from Yale, psychi- 
atrist David Hamburg from the National Institutes of 
Health. 



Joining them were two other big Stanford names who 
had been already in San Francisco, pharmacologist Avram 
Goldstein and radiologist Henry Kaplan. Alway also 
replaced three department chiefs, created a new depart- 
ment of genetics, and added new full professors. 

Almost overnight Stanford medical school was cata- 
pulted to national prominence. The school began to 
attract a medical faculty whose talents and prestige 
enabled them to bring in funds as well as a measure of 
independence. 

The men who were replaced were understandably 
bitter. None were more so than the staff of the old San 
Francisco hospital and most of the medical alumni. 
Their loyalties were with the old school and those pro- 
fessors who believed the talent available in the suburbs 
would offer no match for what Stanford had left behind 
in San Francisco. 

The medical leaders at Stanford disagreed, pointing 
out that under its new curriculum, full-time salaried 
faculty and its proximity to the university, the school 
would be better able not only to teach the best methods 
of caring for patients, but aim to increase knowledge 
and benefit the whole world by its diffusion. 

Inspired by a program undertaken originally by 



IV 




Dean Robert Alway stands before a portrait of Samuel Elias Cooper 
symbolizing the link between past and present. Cooper founded the 
far West's first medical school, Stanford's forerunner. 



Cleveland's Western Reserve University, Stanford's "Five- 
Year Plan for Medical Education" was designed to hu- 
manize the physician by spreading medical studies over 
five years instead of four, teaching students about the 
patient as a whole and emphasizing principles rather 
than the detailed mastery of subjects. The latter was 
important, the curriculum's designers emphasized, 
"because medical frontiers were advancing so rapidly 
that comprehensive coverage of all areas was impractical." 

Medical school freshmen began with wide-ranging 
courses that related to basic medical disciplines. And 
students were encouraged to supplement their medical 
education with independent study or elective courses 
in areas which particularly interested them. By provid- 
ing generous amounts of free time each year, students 
could do research or study related subjects such as 
sociology and psychology, or work for degrees in other 
university departments while earning the medical degree. 

There were those, of course, who feared that because 
medical education was already too long, the five-year 
program might price Stanford's new school out of the 
market. "But when the first class was admitted in 1959," 
recalls Goldstein, "it was greatly overapplied." 

Goldstein, one of the chief architects of the five-year 



plan, maintains he is no curriculum tinkerer. "There's a 
pendulum about curriculum, an urge to keep changing 
it back and forth," he says. "But curriculum is much less 
important than the quality of the institution and its 
teachers and researchers. Nevertheless, the five-year 
program was important because it suggested that Stan- 
ford, unlike most schools that turn out primarily practic- 
ing physicians, could attract an entirely new kind of 
medical student. 

"The thinking behind it was that we would expand 
the time in which students were exposed to the basic 
sciences because we perceived the new era of medicine 
as one in which science would change almost everything." 

"By any yardstick, we've had the most stimulating 
medical students year after year," says Eugene Farber, 
an internationally noted expert on skin disease and 
chairman of dermatology. Farber, who moved to Palo 
Alto from San Francisco, speaks with equal enthusiasm 
about former Stanford medical graduates he has en- 
countered as interns and residents at Stanford hospital. 
"This may sound trite," he explains, "but whenever I 
meet them I feel like I am with eagles." 

Irving Weissman, professor of pathology and himself 
a product of the five-year curriculum, surveyed his 





* • 



|f 



Flanked by David Packard (left), board of trustees chairman, and William Hewlett, hospital board chairman, 
president J. Wallace Sterling begins dedication ceremonies. 



classmates of 1965 seven years ago. Their unanimous 
verdict: it was a remarkably successful experiment in 
medical education. 

"The five-year plan served students very well, irre- 
spective of their eventual career choices," Weissman 
wrote. "Although the class... was certainly an anomaly 
in terms of the high percentage of its graduates who 
ended up in investigational and teaching roles (67 per- 
cent), the satisfaction expressed. . .indicates that the pro- 
gram was compatible with the ambitions of diverse 
medical students." 

An important plus of the five-year program was to 
provide students from the moment of admission with a 
home base laboratory. "We believed in research," ex- 
plains Goldstein, "and you can't do serious researth on 
the basis of a few hours here or there. The Fleischmann 
Laboratories were built to avoid the footloose, shiftless 
system of operation that we knew existed in most med- 
ical schools where students drifted from one classroom 
to another without a sense of belonging anywhere." 

The student labs, open day and night, also decreased 
the burden on departmental laboratories usually pressed 
for space. 

Stanford's experiment in medical education was in 
effect for 10 years when it came abruptly to an end. 

Weissman maintains it was prematurely aborted on 
the basis of a few crucial decisions: the development 
and sale of a four-year track to incoming students, a 
decision to charge five-year students higher tuition than 



four-year students, pressure through capitation sup- 
port by the federal government to increase the class size 
because of a predicted shortage of doctors, and the 
mistaken notion that a small faculty could increase its 
teaching and administrative load. 

The reasons for the demise, Goldstein thinks, were 
far more complex. They included the "student cultural 
revolution of the 1960s with its heavy antiscience thrust 
and anti-intellectualism, misplaced egalitarianism and 
loss of interest among the students of that era in labora- 
tory research." 

These ideas, according to Goldstein, also infected 
many members of the faculty, and the five-year plan 
was replaced by an entirely elective curriculum. 

"As soon as the curriculum became optional for stu- 
dents, it became optional for the faculty as well, coupled 
with a decline of interest in teaching," Goldstein observes. 

And the crunch for laboratory space forced the school 
to divert most of the student laboratories to departmen- 
tal use. 

But in the past few years, a series of faculty senate 
actions were taken, led by Goldstein, to steer the school 
back to the path blazed in 1959. They define the mission 
of the school as that of "providing an educational envi- 
ronment that encourages intellectual stimulation and 
opportunity for self-motivated students who are inter- 
ested in developing a scholarly investigative approach 
to problems in medicine." 

"Our curriculum," the statement goes on, "has a two- 



VI 



STANFORD MEDICINE FALL 1984 




Student labs embodied a new approach to teaching and the principal means by which 
the tenet of educating scientifically trained M.D.s was realized. 



fold purpose: to develop in all students the capacity for 
leadership in the clinical practice of scientific medicine, 
and to provide opportunities for as many students as 
possible to prepare themselves for careers in research 
and teaching the various branches of basic, clinical, and 
social medicine." 

After a decade of retreat, Goldstein adds, a majority 
of the faculty were willing to say, "yes, that's what this 
place is all about, we have a unique mission, we are a 
special kind of school, dedicated to training the intellec- 
tual and scientific leaders of tomorrow's medicine." 

"Everybody agrees that the five-year plan was great, 



but we never really gave it much of a chance," says 
Joshua Lederberg, now president of Rockefeller Univer- 
sity. "There's no reason in the world for Stanford not to 
come back to what was originally a very sound idea." 

This is in fact what is happening. In June 1984, the 
school graduated its smallest class in 10 years. While 
medical school classes have remained constant, ex- 
plained registrar Charlotte Crucean, a larger number of 
medical students have opted to stay an additional year 
to pursue research or take a year off during their studies 
to gain practical clinical experiences. 

The wheel of circumstance has turned full circle. 



MEDICAL CENTER 

AYEARATATIME 



Looking back at two-and-a-half decades of prog- 
ress, which included 10 turbulent years of campus 
anti-war activism, events tend to blur in time; sig- 
nificant developments fade from memory — and 
was it in '68 or '71 that students flew the Mickey 
Mouse flag outside the school and demonstrators 
seized the hospital? For the record, these were 
some highlights and low points: 



THE FIFTIES 



In the Beginning: Stanford president J. Wal- 
lace Sterling was principal actor in the effort 
to relocate the medical school from San Fran- 
cisco to the campus, which began in July, 



1953. The late Windsor Cutting, who became 
dean in 1956, believed in that decision, and 
set the move in motion. But many say Cut- 
ting did not fully understand that radical 
changes were needed to create a world-class 
institution. He resigned, leaving that goal to 
the next dean, pediatrician Robert Alway. 

First Accelerator: The first six-million-volt 
linear accelerator for cancer treatment in the 
Western Hemisphere was installed in Stan- 
ford hospital, San Francisco, in 1956. The re- 
sult of collaboration of radiologist Henry Ka- 
plan and physicists led by Edward Ginzton of 
Stanford's Microwave Laboratory, the accel- 
erator was first used successfully in 1957. By 
the time the school had relocated, Kaplan 



STANFORD MEDICINE FALL 1984 



VII 



THE ANATOMY OF EXCELLENCE 



/s the formal opening of the new medical school 
i drew closer, Dean Robert Alway used a meta- 
m phor about the atomic bomb when he de- 
A. scribed new developments in his bailiwick on 
campus. And it was not surprising. His directness had 
achieved results that could be the envy of any dean — it 
had helped attract new faculty leaders who were clearly 
in the forefront of their profession. 

"We wanted people to work with colleagues who 
would be exciting," Alway explained. And then he turned 
to the bomb metaphor: "Each person brings the school 
closer to the critical mass — closer to an explosion you 
can't control." 

How success was achieved is the substance of this 
report based on interviews with four of the founding 
academic department chairmen. The question put to 
them by Stanford Medicine was, "What ingredients con- 
tributed to excellence in your department?" Their 
thoughtful and provocative answers are presented below: 

'WE WERE DETERMINED TO SHARE 
OUR LANGUAGES' 

by Arthur Romberg, M.D. 

Our department at Washington University consisted of 
Mel Cohn, a molecularly-oriented immunologist, Dale 
Kaiser, a virologist, Dave Hogness who understood 
metabolic regulation in bacteria, and Paul Berg and Bob 
Lehman, who had started as postdoctoral fellows with 
me. They had come to St. Louis to be part of the depart- 
ment of microbiology, which had succeeded the classic 
department of bacteriology and immunology. We were 
all oriented to teaching biochemistry and the genetic 
basis of cellular organization and development. Teach- 
ing diagnostic bacteriology was no longer as important, 
I felt, as it had been. I had the conviction then and still 
do that biochemistry is the keystone of education and 
the practice of medicine. 




The opportunity to come to Stanford to become a 
bona fide biochemistry department was a major consid- 
eration in our move. We were to be a new department 
unencumbered by a residue of people with ideas and 
styles that would have to be slowly modified. 

I remember the excitement, the anticipation I felt with 
the kinds of things Avram Goldstein and Henry Kaplan 
were talking about. Among these was the new curricu- 
lum that was interesting, innovative and designed to 
provide a bright future for the scientific basis of medicine. 

In our beginnings at Stanford, the department con- 
sisted of the six of us from St. Louis and R. L. (Buzz) 
Baldwin, a physical biochemist from Wisconsin. We 
were only half the size of standard biochemistry depart- 
ments elsewhere. I felt then and still do that an optimal 
size for a department is about 10 full-time faculty 
members. 

The essence of the cohesiveness that characterizes the 



25 



YEARS" 



had developed optimal techniques necessary 
to begin treating large numbers of patients. 

The Opening: Stanford Medical Center was 
dedicated Sept. 17, 1959. Architect Edward 
Durell Stone designed the hospital, clinics, 
medical school and Lane Medical Library to 
be all under one roof. The 56-acre, $27-mil- 
lion complex had taken four years to plan and 
build. Two complementary aims — to achieve 
an expanded and modernized facility for the 
people of Palo Alto and to replace Stanford 
School of Medicine in San Francisco — led to a 
unique partnership between the city and 
Stanford University. It was the 420-bed Palo 



Alto-Stanford Hospital Center as an integral 
part of the Stanford Medical Center, with two 
separate medical staffs — community and fac- 
ulty — and shared beds and equipment. 

THE SIXTIES 

First Open Heart: The first open-heart opera- 
tion performed at Palo Alto-Stanford Hospi- 
tal Center in Jan. 8, 1960 was to correct a sep- 
tal atrial defect. The surgeon: young, 
unknown assistant professor Norman 
Shumway. 

Bed Crunch: After only six months in opera- 
tion, the new hospital reported a census 



boom confirming official fears that 420 beds 
were not enough. Renovation plans surfaced 
to put the old Palo Alto Hospital building 
back in service. Soon after, the hospital board 
approved a $1 . 1-million refurbishing plan. 
Constructed near El Camino Real in 1931 as a 
city-Stanford enterprise, the old structure 
was to have been closed. 

Accreditation: The hospital center received 
its first three-year accreditation in August, 
I960, from the Joint Commission on Accredi- 
tation of Hospitals. 



VIII 



Stanford biochemistry department is sharing most 
everything. It sounds simple, but it comes down to 
things that usually divide people. We share money and 
space, there are no territorial prerogatives. We share in 
the decisions to select and admit students. We make it 
easy for them to switch advisors without ill feeling, and 
we show continual concern for them. We provide ample 
room for individual expression, but most important we 
share in the successes that people have occasionally. 

Our department is now known as a DNA depart- 
ment. But it wasn't that when we came to Stanford. We 
were working on a variety of things. We were deter- 
mined to share our languages. We had noon seminars 
at least three times a week. We met to review papers, 
and to hear reports from students and fellows. We met 
as a group to discuss techniques and materials. In this 
way we retained a common language. When you under- 
stand what others are doing, there is sympathy and 
respect. Eventually gaps are bridged and often one ends 
up doing related things. 

Administratively, we developed a rotating chairman- 
ship. It's an effective system. When I resigned as chair- 
man, I continued to feel the same sense of responsibility 
as the others did when I was chairman. 

Over the years our faculty expanded modestly and 
we added space. But the price is some dilution of inter- 
actions. People don't bump into each other as often. In 
a research environment the collision frequency between 
people is terribly important. It is even more important 
nowadays when people are away so much and have so 
many external responsibilities. 

As for our accomplishments, we are responsible for 
some share in the recent revolutionary development of 
DNA. The explosive advances in genetic engineering, 
or biotechnology, as some call it euphemistically, have 
benefited from significant contributions of everyone in 
our department. Our research was not designed for 
practical applications. None of us anticipated that our 
work on DNA would lead to major applications in med- 
icine and industry. 

It is reassuring that our research efforts have been 
recognized. But most important is the satisfaction that 
we've done good science and there is little else limiting 
our creativity but ourselves. I tell students and fellows 
the only tenure that matters in science is the environ- 
ment to do creative work. The title and related things 



are trivial. If you have the drive to do something, and 
you're given modest space and resources, you can do it. 

Arthur Kornberg, Nobel laureate in medicine, arrived in the 
summer of 1959 with five members of his faculty team from 
Washington University to set up Stanford's biochemistry de- 
partment. He and his colleagues had isolated an important 
enzyme which stimulates production of DNA, the complex 
molecule which determines heredity in all living things. Using 
this enzyme, Kornberg hud produced DNA in the test tube 
which was exactly like that found in nature. During his tenure 
as chairman, Kornberg played a pivotal role in the affairs of the 
medical school while leading research to untwist the double 
helix of simple bacteria and unlock its replication secrets. The 
department he established boasts one more Nobel prize won by 
Paul Berg in 1980; seven of the nine faculty are members of the 
National Academy of Sciences. 



'FOCUS WAS THE KEY' 



by Avram Goldstein, M.D. 

The secret of a great department is having a theme. 
Many people disagree with this, but I believe in theme 
orientation. It's the ingredient that holds people to- 
gether and stimulates them to great accomplishments. 
That's what built Arthur Kornberg's department. In the 
early days everybody in his department worked on 
some aspect of nucleic acids. Later, some branched out 
in other areas of biochemistry, but even so it was still 
heavily oriented in that direction. 




First Kidney Transplant: The hospital's 
first kidney transplant operation was per- 
formed in August, 1960 by professor Roy 
Cohn and associate professor Harry Oberhel- 
man. The kidney came from the patient's 
twin brother. 

Exobiology: Nobel laureate Joshua Leder- 
berg, genetics department chairman, made 
headlines when the National Aeronautics 
and Space Administration announced he and 
associates would design instruments to 
search for microscopic life on other planets. 
"Mars was the likeliest target for 'exobiol- 
ogy,' " said Lederberg, who coined the term 
to describe the emerging field of extraterres- 
trial science. 



Cancer Center: The hospital opened a 15-bed 
Clinical Radiotherapy Cancer Center, di- 
rected by Henry Kaplan and Malcolm Bag- 
shaw. It was one of eight units established by 
the National Cancer Institute in the U.S. to 
carry out clinical trials of promising cancer 
treatments. 

Parking Plans: Parking problems came 
sooner than expected with the influx of pa- 
tients, students, visitors and volunteers to 
the new medical center. The center's first 
parking plan called for separate stickers for 
professors, students and staff, and an added 
aggravation: a locked gate on the road lead- 
ing to the emergency room, which was 
closed for all but ambulances equipped with 
a "passkey." 



Kennedy Laboratories: With support from 
the John P. Kennedy, Jr. Memorial Founda- 
tion, the medical school announced new pro- 
grams of education and research in the field 
of mental retardation, to be housed in the 
new Clinical Sciences Research Building. 

A First: The first West Coast center for chil- 
dren with childhood aphasia was established 
by the medical school's Division of Speech 
Pathology and Audiology under the direction 
of noted expert Jon Eisenson. 

Heart Swaps in Dogs: Surgeons Norman 
Shumway, Richard Lower, Eugene Dong and 
Edward Hurley in April, 1962 reported they 
had removed dogs' hearts for up to two 
hours, then replaced them without apparent 



IX 



The pharmacology department has been strongly ori- 
ented toward molecular approaches. We wanted our 
department to be in the forefront of the new movement 
I called molecular pharmacology. We never tried to do 
anything else, not clinical pharmacology, not physio- 
logical or behavioral pharmacology. We chose a single 
focus, and focus was the key to success. 

For example, Bob Schimke's very important early work 
on gene amplification was done while he was a member 
of our department. The work of [present chairman] Tag 
Mansour on the biochemical and molecular pharmacol- 
ogy of parasites has important implications for novel 
treatments of parasitic diseases throughout the under- 
developed countries of the world. Dora Goldstein's pi- 
oneering work on alcohol and cell membranes has ex- 
posed what most people now recognize as the mechanism 
of action of alcohol as a drug. 

My own work on the opioid (morphine-like) brain 
peptides (including dynorphin, which we identified 
several years ago) was part of the same thematic focus. 
We pioneered the search for opioid receptors by first 
demonstrating their existence in brain tissue through a 
technique later universally adopted. The opioid pep- 
tides would be implicated ultimately in natural pain 
control, acupuncture analgesia, opiate addiction, and 
numerous aspects of brain function, shedding new light 
on the pharmacology of morphine. 

We established a distinguished though quite small 
pharmacology department that for years was rated among 
the top two in the nation. Recently, under Tag Man- 
sour's chairmanship, the emphasis on molecular phar- 
macology has been strengthened by the addition of five 
younger faculty members who are practitioners of the 
exciting new recombinant DNA technology. 

Avram Goldstein is considered one of the architects of the new 
Stanford medical school during the move in 1959. He headed 
the department of pharmacology from 1955 to 1971 when he 
resigned his post to devote his energies to research and teach- 
ing. He founded the Addiction Research Foundation in 1974, 
a nonprofit organization whose aim is to develop basic infor- 
mation about the chemical basis of drug addictions. He is 
founder of the journal Molecular Pharmacology, a member 
of the National Academy of Sciences, and a recipient of numer- 
ous honors including the Franklin Medal and the highest honor 
in American pharmacology, the Sollmann Award. 




'WE WERE NOT LOCKED INTO 
ESTABLISHED PATTERNS' 



by David Hamburg, M.D. 

My chief attraction to Stanford was the people, what 
Henry Kaplan and Bob Alway used to call "intellectual 
playmates." These were strong academic chairmen with 
a sense of the importance of innovation. When I was 
interviewed for the psychiatry chairmanship they con- 
veyed to me that any reasonable new idea would get a 
fair hearing, that the school was not locked into rigid 
patterns. 

This was important because psychiatry in those days 
was in dire need of building a strong scientific base. To 
do so in a setting like Stanford required dynamic inter- 
play between basic and clinical disciplines, including 
the behavioral and biological sciences on campus. 

After I had been on the job for awhile, Bob Alway 
used to kid me, saying, "When are you going to appoint 
a psychiatrist?" That was because in my early recruit- 
ment efforts I went after basic scientists, and it was 
almost unprecedented in psychiatry to build a depart- 
ment that way. It seemed to me though that we had to 
think about strong, innovative, cutting-edge-type of 
research and clinical programs. An example on the so- 
cial side is what the department has achieved with Irvin 
Yalom and Rudolf Moos, and on the basic research side 
with Jack Barchas. 



25 



YEARS" 



harm. This, they said, was the first step to 
make heart transplantation feasible in 
humans. 

Chain Reaction: The hospital opened two re- 
search centers for human disease studies 
under grants by the National Institutes of 
Health to the medical school, including the 
first NIH center ever to study premature 
infants. 

Accelerator Industry: New gleaming ver- 
sions of the medical school's once experimen- 
tal linear accelerator for cancer treatment 
went into use at UCLA Medical Center and 
Palo Alto-Stanford Hospital Center in No- 



vember, 1962, marking the first export of 
Stanford-developed therapeutic technology. 

Lasers for Retinas: Ophthalmologists Milton 
Flocks and Christian Zweng, clinical faculty 
members, demonstrated the use of lasers to 
weld detached retinas in animals before a 
group of eye specialists. The laser was devel- 
oped by an NIH grant to Palo Alto Medical 
Research Foundation. Soon after, they re- 
ported successful use of the laser to treat reti- 
nal detachment in patients. 

Mission Accomplished: Medical school dean 
Robert Alway resigned, noting the accom- 
plishment from 1957 through 1964 of objec- 
tives of the school's relocation and executive 



reorganization. Sidney Raffel, microbiology 
chairman, succeeded Alway as acting dean. 

Blue Babies: Norman Shumway told an 
American Heart Association meeting that 
complete cure of "blue baby" heart defects 
could be accomplished with negligible risk. 
Of 43 consecutive operations performed at 
Stanford, mortality was zero and patients 
subsequently had normal functioning hearts. 
Many surgeons were still reluctant to per- 
form the operation even though he said it 
could be done safely. 



Yalom was interested in inpatient group therapy within 
different contexts, including psychiatric hospitals 
undergoing change. Moos has been concerned with 
treatment environments and the way people cope with 
stress and life crises. Barchas and others have been 
researching exclusively the basic causes of psychiatric 
illness at the neurochemical level. The strategy was to 
get clinicians immersed in contact with basic scientists. 
This was extremely beneficial. Our people became bridges 
to other university departments, and the intellectual 
stimulation was tremendous. 

Joshua Lederberg and I shared a view that profes- 
sional schools in the university ought to be part of 
undergraduate education. We organized a course on 
"Man as an Organism," the forerunner of the human 
biology program which symbolized the openness to 
innovation and broadening of outlook across disciplines 
that I had found so attractive about Stanford. 

Our faculty was encouraged to take posts in clinical 
services such as medicine, pediatrics and surgery. I 
thought it was important for us to be exposed to psychi- 



atric aspects of clinical problems presented in these 
settings. Our primate research became a very intimate 
ongoing interplay between laboratory and field studies 
on the relationship of hormones to behavior. 

Work by Betty Hamburg put the study of early ado- 
lescence on the map. In those days people did not fully 
appreciate its importance. We made some lasting con- 
tributions in increasing scientific awareness in early 
adolescence as a major phase of the lifespan with clinical 
implications. 

David Hamburg became chairman of the psychiatry depart- 
ment at Stanford in 1961 . He came from the National Institute 
of Mental Health in Bethesda, where he was chief of the adult 
psychiatry branch. An expert on the effects of psychological 
stress on human behavior, Hamburg resigned as chairman in 
1972 to return to research and teaching. Later he became 
president of the Institute of Medicine of the National Academy 
of Sciences and held posts at the Kennedy Policy Center at 
Harvard before assuming his present position as president of 
the Carnegie Corporation in New York. 



'I INSISTED ON LABORATORY SPACE 
FROM THE START' 

by Henry S. Kaplan, M.D. 

When I became department chairman in 1948 not a 
single department of radiology in the world did scien- 
tific research. The only thing being called research for 
diagnostic radiologists was to sit on their butts in front 
of a viewing box and look at films and perhaps collect 
one or two cases of some rare malformation. That was 
the only notion of research. 

I felt it was very important for therapeutic radiology 
to have an experimental as well as a clinical research 
base. I insisted on laboratory space from the start. I felt 
intuitively that it was no good having a department 
chairman make big speeches about how important re- 
search is and himself doing no research whatever. I felt, 
on the contrary, that in radiology, which was then so 
backward with respect to research, that the only way it 
would work was for me was to see just as many films, 
just as many patients as anybody else, and to be chair- 
man on top of that and do research. That would shame 



my faculty into feeling that they too could and should 
do research. Obviously, not everyone I selected turned 
out to be a red-hot research man. But in the course of 
time I weeded out most of the ones who were not 
productive in both areas — the laboratory and the bedside. 

If my endeavors had a focus on some central theme, 
you might say I created the idea of doing laboratory 
research in an academic department of radiology, and I 
insisted on doing it myself partly because I was inter- 
ested and because it closed off an escape hatch for other 
faculty members who could have found excuses for not 
doing research. 

But there is another point to be made on the issue of 
what makes a good or great clinical department. I fre- 
quently stressed to our faculty that no matter what else 
was going on, it was a given that the quality of patient 
care in the department had to be absolutely first class. 
We could not undercut the quality of patient care just to 
find more time for our research. 



These remarks by the late Henry Kaplan are based on inter- 
views he gave to Stanford Medicine prior to his death from 
lung cancer in February 1984. More on Dr. Kaplan appears in 
the "Farewell" section. 



Harvard Man at the Helm: Robert Glaser of 
Harvard Medical School was appointed vice 
president for medical affairs and medical 
school dean. 

Man's Best Friend: A dog, "Ralphie," lived 
with a transplanted heart from another dog 
for more than a year, paving way for Stan- 
ford's first human clinical trials. 

Aid for Hemophiliacs: Stanford researcher 
Judith Pool developed a new technique for 
extracting antihemophilic globulin (AHG), 
the blood fraction needed to prevent bleed- 
ing in hemophiliacs. The method could be 
carried out in any blood bank or hospital, and 



once the fraction was removed, the rest of the 
blood was available for regular transfusions. 
The fraction was 15 times as concentrated as 
in normal blood plasma, and it meant hemo- 
philiacs no longer needed treatments with 
whole plasma liquid that overloaded 
circulation. 

Hoover Opened: After major renovation, 
Palo Alto Hospital, renamed Hoover Pavil- 
ion, formally reopened May 15, 1965. 

Pacesetting Ear Surgery: The first extensive 
electrical stimulations of the auditory nerve 
in man to treat deafness were reported by 



otolaryngologist Blair Simmons and associ- 
ates in June, 1965. The studies suggested that 
speech communication via direct nerve stim- 
ulation was possible, paving the way for de- 
velopment of implantable artificial hearing 
devices. 

Preemies Treatment: Pediatricians Philip 
Sunshine, Irwin Schafer and Marshall Klaus 
and anesthesiologist Vernon Thomas re- 
ported successful application of respiratory 
therapy to infants with hyaline membrane 
disease, a respiratory distress syndrome that 
affects more than 25,000 newborns in the 
U.S. The therapy, common in adults with 
breathing difficulties, rarely had been ap- 
plied to infants. 



XI 



PACESETTERS 



Stanford medical school relocated from San Francisco to 
the campus at a time when a national commitment had 
been made to accelerate biomedical research and a crea- 
tive atmosphere was leading to a scientific revolution 
which altered the character of medicine. Looking back, Ameri- 
can medicine changed more from the '60s through the '80s 
than in any preceding period. 

Fundamental discoveries in biology, technological develop- 
ments in new diagnostic and therapeutic tools and changes in 
treatments sparked the changes. The modern hospital is the 
most conspicuous result, transformed from a place where pa- 
tients went to die into a place where they can enter with 
confidence that they will be helped. The elaborate division of 
doctors into specialties and subspecialties is a result of the 
accumulation of knowledge and capability to help the sick in 
the most diverse ways. 

For skeptics who doubt this progress, consider this evidence. 
In 1979, infant mortality in the United States was 13.0 deaths 
per thousand live births, precisely one-half the 26.0 deaths per 
thousand live births in 1960. And whereas in 1960, life expect- 
ancy at birth was 66.6 years for American males and 73.1 
years for females, for 1979 and 1980, those same expectancies 
have been raised to 70 and 78 years respectively. 

Unlike previous revolutions, the biomedical revolution was 
an interacting one, with fundamental discoveries of the labo- 
ratory applied rapidly for the benefit of patients. Following is 
a gallery of just a few of the Stanford faculty whose contribu- 
tions both at the bedside and laboratory are widely recognized 
as part of this revolution. 

ROSE PAYNE, Ph.D. 

Payne leaped to fame in the early '50s when she 
confirmed earlier scientists' observations that white blood 
cells of the body produce antibodies against invading 
foreign substances. Using new techniques, she found 
that patients who developed antibodies had received 
blood transfusions to which their white blood cells had 




Payne 

reacted by forming protective shields against the for- 
eign blood. Fever and chills followed. Others confirmed 
her conclusions, and a way was found to prevent this 
reaction by removing the white cells from blood prior to 
transfusion. The discovery brought a new phrase into 
medicine — "human leukocyte antigens," or HLA. These 
antigens are protein molecules whose structures are 
specified by genes deep in the cell nucleus. The antigens 
recognize foreign substances, including transplanted 
organs, as they enter the body and provoke a defensive 
reponse against them. Payne's laboratory played a key 
role in applying tissue matching techniques to deter- 
mine the genetic compatibility of donor and recipient, 
thus contributing to success of organ transplants. 

NORMAN E. SHUMWAY, M.D. 

In animal experiments that preceded the historic 
transplantation of the first human heart in South Africa 
by 10 years, Shumway and his colleague Richard Lower 
(now at the Medical College of Virginia) had developed 



25 



YEARS" 



Triple Heart Valves: Multiple heart valve re- 
placement, a rare procedure in the early '60s, 
could be accomplished safely in one single 
operation, Shumway reported after his team 
did 28 at Stanford with only one death. 

First Addition: New clinical sciences re- 
search building dedicated May 26, 1966. 

Inhalation Therapists: The first academically 
trained inhalation therapists in the U.S. grad- 
uated in 1966 from the hospital center and 
Foothill College's program. 



Coronary Care: Thanks to community physi- 
cians, the hospital center's coronary care unit 
opened Sept. 26, 1966. The four-bed CCU 
was developed by cardiologist Alfred P. Spi- 
vack and Stanford Kroopf, chairman of Palo 
Alto medical staff's coronary care committee. 
Spivack was CCU's first director. 

Computer Marvels: The medical schools' first 
computing facility, ACME (Advanced Com- 
puter for Medical Research), was constructed 
under an NIH grant. 

Best Hospital: Palo Alto-Stanford Hospital 
Center was ranked a top-10 hospital in the 
U.S. by a panel of experts in a 1967 national 
poU. 



Divorce: Citing "unwieldy" organizational 
arrangements and the hospital's unrespon- 
siveness to teaching and research needs of 
the medical school, Dean Robert Glaser and 
university president Wallace Sterling pro- 
posed negotiations between Palo Alto city 
council and Stanford to acquire the city's 
share of the hospital. 

New Hospital Plans: The medical school re- 
ceived trustee approval and a $500,000 grant 
from the Commonwealth Fund of New York 
to plan a new basic science building for the 
departments of anatomy, physiology and 



XII 




Shumwav 

the surgical techniques as well as regimens to control 
rejection and had reported the first successful heart 
transplant in a dog. By the time human heart trans- 
plants had begun, Shumway's group had the experi- 
ence and track record to enter the field with confidence. 
When others abandoned heart transplants, discouraged 
by dismal mortality rates, Shumway persevered. For a 
while his was the only group in the world transplanting 
hearts. Shumway's group also succeeded in transplant- 
ing combined hearts and lungs. Encouraged by his track 
record, surgeons elsewhere have resumed heart trans- 
plants. Equally significant are the spinoffs of his pro- 
gram in other areas of medicine, to say nothing of 
Shumway's influence in having trained some of the best 
cardiovascular surgeons in the world. 

PAUL BERG, Ph.D. 

A 1980 Nobel Prize recipient in chemistry for contri- 
butions that made DNA recombination a reality, Berg 
also shares the distinction of shaping a responsible 
policy for dealing with its possible risks. Over the years, 
he has developed novel techniques allowing research- 
ers to examine the structure and control of genes of 
higher organisms in a way previously unimagined. The 
Swedish Royal Academy honored him for "his funda- 
mental studies of the biochemistry of nucleic acids, with 




particular regard to recombinant DNA." In the past 
decade recombinant DNA techniques have become in- 
creasingly sophisticated, with Berg and others playing 
a major role. His goal, as he states it, "is to understand 
how gene action is regulated during development and 
how these processes and reactions go awry in disease. 
Perhaps then our attempts at diagnosis, prevention and 
cure of disease can be made more rational and effective." 

HUGH McDEVITT, M.D. 

It has long been known to medical science that some 
people are vulnerable to diseases that run in families. 
But even though many widespread disorders — such as 
rheumatoid arthritis and multiple sclerosis — have been 
linked to heredity, no means has existed to spot individ- 
ual susceptibility to them and to start treatment before 
they attack their victims. In the mid '60s McDevitt and 
his group discovered that immune response genes con- 
trolling the body's response to infection are clustered 
together on one chromosome in the mouse and are 
closely linked to genes responsible for destroying tissue 
grafts. Because these genes direct production of HLA, 
the protein molecules involved in the body's defense 
system, it was clear that McDevitt had found a unique 
pointer of human vulnerability to certain diseases. By 
the early '70s, groups in Los Angeles and London had 



medical microbiology, and a new hospital 
and ambulatory care center. Beltrand Gold- 
berg Associates of Chicago were appointed 
consultants for the projects and development 
of a center-wide master plan. 

Babies in Distress: An electronic monitoring 
system to aid infants suffering from respira- 
tory disorders was developed by Stanford 
pediatricians and engineers from Beckman 
Medical Instruments. 



In the Test Tube: Nobel laureate Arthur 
Kornberg and associates reported the test- 
tube synthesis of infectious viral DNA dis- 
playing full biological activity. That such a 
feat was possible had been demonstrated in 
all DNA work done since 1960, and neither 
Kornberg nor others regarded it as a "break- 
through." Nevertheless, it received much 
public attention because it was the first time 
anyone had taken 5,300 nucleotide building 
blocks off the shelf and used an enzyme to 
string them together in precise sequence to 
produce an infectious DNA molecule. The 
development was sensationalized when 
President Lyndon B. Johnson, at a dinner 



speech at the Smithsonian Institution in 
Washington, mentioned Kornberg's work 
and described it as "creation of life in the test 
tube." 

Another First: The first heart transplant in an 
adult patient in the U.S. was performed at 
the hospital center Jan. 6, 1969 by Norman 
Shumway, Edward Stinson, Eugene Dong 
and colleagues. The patient, 54-year-old Mike 
Kasperak, died 15 days later from what 
Shumway termed "a galaxy of complications 
involving the lungs, liver, and kidneys." This 



XIII 




Cohen 



established the first link between such genes and a form 
of arthritis in man. By 1980 links had been established 
in other rheumatic conditions, as well as neurological, 
endocrine, gastrointestinal and skin disorders, pointing 
to a new predictive power of medicine with early treat- 
ment or prevention of some diseases becoming possible. 

STANLEY COHEN, M.D. 

While many contributed to recombinant DNA re- 
search, it was molecular geneticist Cohen, Annie Chang 
at Stanford and Herbert Boyer at the University of Cali- 
fornia, San Francisco that made it practical. The heart of 
recombinant DNA technology is not just gene splicing 
but also gene cloning. It involves techniques to get 
genes into cells, ensures that the genes are expressed, 
and then selects for the cells that are expressing those 
genes. Cohen and his colleagues in the early 1970s 
developed a plasmid, a small piece of extra-chromo- 
somal DNA, and used it successfully to carry foreign 
genes into bacterial cells. The ability to clone and manip- 
ulate DNA molecules introduced into bacteria and cells 
of higher organisms has enabled the study of gene 



organization at a new level. It has also sparked the 
development of a biotechnology industry and rapid 
successes as production by "bacterial factories" of bio- 
logically active hormones such as insulin, somatostatin, 
human growth factor, and anti-virals. Cohen's contri- 
butions have been recognized by the prestigious 1981 
Wolf Prize, the American Chemical Society's Marvin 
Johnson Award, and the 1980 Albert Lasker Medical 
Research Award. 

NORMAN KRETCHMER, M.D. 

Kretchmer led Stanford's pediatrics program for 10 
years, broadening its scope to include the molecular, 
physiologic and behavioral aspects of human growth 
and development. Two years after he arrived from Cor- 
nell, he obtained the first award from the National Insti- 
tutes of Health to develop a clinical research center for 
premature infants. This was the precursor of today's 
expanded thrust in neonatology as well as other pro- 
grams developed by Irving Schulman, present chair- 
man. Kretchmer established research and training in 
the field of developmental biochemistry, an effort that 
united research and clinical work toward a biochemical 
understanding of birth defects, metabolic diseases and 
mental retardation. Internationally, he was an influen- 
tial voice on issues of malnutrition and risks to human 
reproduction of pesticide exposure. In 1969, when he 
left to head the National Institute of Child Health and 
Human Development in Bethesda, Kretchmer had just 
completed a term on the committee responsible for 
development of Stanford's undergraduate program in 
human biology. He is presently on the faculty of the 
University of California at San Francisco. 

JOHN HANBERY, M.D. 

Hanbery, affectionately called Jake by his students 
and Stanford associates, has headed neurosurgery for 
22 years. If you ask what they think of him, these words 
come up frequently. "The best, most reliable, most re- 
spected neurosurgeon in the country. He's the proto- 
type of dignity, total dedication, completely immersed 
in exemplary habits of patient care — a truly great sur- 
geon." If anything comes before his students, it's pa- 
tients. Hanbery has fought aggressively for research 



25 



YEARS" 



and two subsequent cases confirmed Shum- 
way's theory that heart transplants would of- 
fer little to patients whose death is imminent 
from effects of chronic heart failure on other 
organs. With revised selection criteria, 
Shum way's third and fourth recipients did 
remarkably well, converting his theory into 
fact. 

Hospital Ownership: Stanford University be- 
came the sole owner of the hospital under an 
agreement approved July 1, 1968 by Palo Al- 
to's city council. Stanford paid $1 million 



cash to the city, assumed $3.5 million worth 
of hospital construction bond payments over 
20 years and guaranteed specified commu- 
nity hospital services until 2008. Private phy- 
sicians on the medical staff retained affilia- 
tion, plus priority to admit patients to 370 of 
the hospital's 663 beds. 

Nuclear Medicine: A technique, radioiso- 
topic angiocardiography, was developed by 
Joseph Kriss and associates in the nuclear 
medicine division and genetics instrumenta- 



tion laboratory to expedite heart disease di- 
agnosis. It enabled the recording and display 
of movement of radioactive material flowing 
through hearts and lungs. 

Crucial Departure: Glaser resigned to join 
the Commonwealth Fund of New York. In 
four years, Glaser had dealt with principal is- 
sues, appointed key faculty, created a master 
plan, launched a minority student program, 
and concluded the hospital purchase. His de- 
parture, coupled with faculty apprehensions 
and preoccupation of university administra- 
tors with a growing campus anti-war activ- 
ism, had negative effects. New hospital and 



XIV 



spearheaded by others in his division, but he has re- 
mained primarily a clinical doctor and a great teacher of 
future neurosurgeons. 

DORA GOLDSTEIN, M.D. 

Since 1966, Goldstein has worked almost exclusively 
on the physiological effects of alcohol. She is credited 
for key discoveries on how alcohol affects the human 
body. She developed techniques enabling her to create 
an animal model of alcohol and drug dependency which 
became the basis for most of the current theories on the 
role of alcohol as a drug. Goldstein has also studied the 
molecular changes that occur in the cell membranes of 
mice subjected to ethanol treatment, suggesting that the 
membranes themselves adapt to the drug, a novel form 
of drug tolerance. 

SAUL ROSENBERG, M.D. 

Oncologist Rosenberg has received international ac- 
claim for his research on Hodgkin's disease. With pi- 
oneer Henry Kaplan, he has made dramatic advances in 
the diagnosis and treatment of the disease. These have 
led to better than 80 percent survival at five years for all 
stages, with 75 percent of the patients being perma- 
nently cured. Rosenberg spearheaded the development 
of oncology, helped establish training programs for 
physicians, and made it a successful, respectable field 
in internal medicine. 

ROY COHN, M.D. 

Like many of his famous predecessors in the surgical 
department, Cohn bears the mark of the Stanford man 
engraved in his character — a constant striving for the 
worthwhile, a love of the strenuous life in work and in 
play and the ability to smile at his own foibles. Now 
formally retired but still involved, Cohn characterizes 
the best that was and is in the medical school. As a 
surgeon and researcher in the early '60s, Cohn and the 
late Samuel Kountz concentrated on kidney transplan- 
tation. His papers on the relationship of blood flow in 
kidney and homograft reaction are considered land- 
mark contributions. From 1963 through 1966 Stanford 
was a leader in the field of kidney transplantation under 




Goldstein 

Cohn's leadership. In spite of it, school leaders of that 
time were dubious about the future of organ transplan- 
tation and were reluctant to invest in people and re- 
sources to continue it. They were wrong, and current 
plans call for the resumption of kidney transplants at 
Stanford in the near future. 

EUGENE FARBER, M.D. 

It can be said that at Stanford the study of the skin 
assumed its rightful place under Farber's leadership. 
Determined to bring the neglected dermatology field up 
to date, Farber gathered clinicians and basic scientists to 
work together on the belief that abnormal skin condi- 
tions could not be helped without basic knowledge . The 
studies clarified the relationship of psoriasis to arthritis 
and demonstrated it to be an inherited disease of the 
entire skin. He developed an epidemiological map of 
psoriasis through study of patient records from abroad, 
stimulating worldwide interest in psoriasis research. In 
the '50s he and the late Henry Kaplan co-developed an 



science building plans were tabled 
indefinitely. 

THE SEVENTIES 

Violence: Dismissal of a black hospital hou- 
sekeeper in April, 1971 led to a 30-hour sit-in 
by some employees and an outside group 
waving North Vietnamese flags. They al- 
leged the employee's firing was "racially in- 
spired" and demanded his rehiring. The hos- 
pital said it would accelerate its "affirmative 
action" programs but refused to rehire the 
employee, who had been fired for cause. 
When police were called, a riot ensued, caus- 



ing more than $100,000 damage to the hospi- 
tal, arrest of 23 demonstrators, and injuries to 
more than 20 people. 

Genes-Disease Link: Immunologist Hugh 
McDevitt discovered a new class of regula- 
tory genes that control the body's immune 
responses to foreign substances like viruses 
and bacteria. The finding suggested that peo- 
ple may have predictable genetic susceptibil- 
ity to certain diseases. 

Argon Laser: Stanford, Palo Alto Medical Re- 
search Foundation and SRI International re- 



ported development of an argon gas laser to 
treat retinal disease. The argon laser's blue- 
green light was better suited for treatment 
because it was absorbed by red blood pig- 
ment, explained ophthalmologist Christian 
Zweng. 

Sonar for Hearts: Sonic impulses bounced 
against hearts' interior walls were found to 
provide useful information about heartbeat 
and blood circulation. The new use of sonar 
or ultrasound was adapted for medical diag- 
nostic work by Stanford cardiology chief 
Donald Harrison and NASA- Ames Research 
Center scientists. 



XV 




Farber 

effective treatment for mycosis fungoides, a skin lym- 
phoma. Since then, Stanford, through use of electron 
beam therapy, has treated the largest number of patients 
with this form of cancer. Farber's efforts led also to novel 
treatments for psoriasis, making Stanford a leading cen- 
ter for the study and treatment of skin disease. 

WILLIAM DEMENT, M.D. 

In the early '50s, with colleagues at the University of 
Chicago, Dement discovered that sleeping human vol- 
unteers showed episodic flurries of rapid, jerky, syn- 
chronous eye movements. Studies showed that the eye 
movements occurred only in association with a particu- 
lar stage of brain wave activity, which appeared and 
reappeared with regularity every 90 minutes through- 
out the night. To distinguish these periods from the 
remainder of sleep, the term "rapid eye movement" 
(REM) sleep was coined. At Stanford since 1963, De- 
ment became one of the world's leading authorities on 
sleep disorders. His research has contributed to under- 
standing of narcolepsy, sleep apnea, sudden infant death 
syndrome, the effects of sleeping pills and insomnia. 
Through the Sleep Disorders Clinic and Laboratory, 



which Dement has directed since 1970, many of his 
findings have been applied for the benefit of patients 
with severe sleep problems. 

THOMAS STAMEY, M.D. 

Quiet, friendly and understated, Stamey is consid- 
ered a leader in the field of urology. His research, con- 
ducted in the urology division which he has directed 
since 1962, led to a drastic change in the understanding 
and treatment of recurrent urinary tract infections, a 
stubborn problem for patients and their doctors. His 
work focused on differences between infections con- 
fined to the bladder and those involving one or both 
kidneys as well. Stamey's studies led to effective anti- 
biotic treatments and revealed the existence of a natural 
antibacterial factor in prostatic fluid. This factor is now 
believed to keep male urinary tract infections to a mini- 
mum — they are only about one-tenth as frequent in 
males as in females. "Although we're known at least in 
the urologic world for our investigative efforts, all of our 
research has essentially been set up around patients," 
he says. "I think we ought to investigate things that 
have some chance of touching on the lives of people." 

JOSHUA LEDERBERG, Ph.D. 

From 1959 to 1978, when he left the medical school to 
become president of Rockefeller University, Nobel lau- 
reate geneticist Lederberg was Stanford's "man for all 
seasons." From the intricacies of the cell to the search 
for life on other planets, Lederberg's ideas have had 
enormous impact on the university, catalyzing the inter- 
ests of faculty in many fields. He directed the Kennedy 
Laboratories for Molecular Medicine, whose research in 
mental retardation evolved into the department of neu- 
robiology. He became involved in the development of 
the human biology program for undergraduates. In the 
early '60s, with physicists and engineers, he experi- 
mented with ways to detect microorganisms on Mars 
and developed mass spectrometry instruments which 
could detect complex organic molecules. It was such 
equipment that went aboard the Viking spacecraft and 
reached Mars in 1976. During his involvement with the 
space program, Lederberg became schooled in organic 
chemistry and the use of computers for data analysis 



25 



YEARS 

Bissinger Center: Radiation Therapy dedi- 
cated a new $l-million center named in honor 
of San Francisco businessman Paul A. Bissin- 
ger who spearheaded the fund drive through 
a group he founded, Friends of Radiology. 

New VP and Dean: Clayton Rich from the 
University of Washington was appointed vice 
president for medical affairs and medical 
school dean. 

Cell Sorter: Using space-age technology, ge- 
netics professor Leonard Herzenberg and 
colleagues developed a revolutionary new 
tool for studying basic cell biology. Called the 
fluorescence-activated cell sorter (FACS), it 



enables scientists to identify and isolate 
closely related types of animal cells at rates of 
up to 5,000 cells per second. FACS machines 
are aiding basic research in laboratories 
throughout the world. 

Casualty: Stanford's School of Nursing was 
closed. 

Nerve Growth Factor: A hormone called 
NGF for short was isolated and crystallized 
by neurobiologist Eric Shooter and col- 
leagues. Discovered by Italian scientist Rita 
Levi-Montalcini in 1950, NGF is necessary for 
development of nerve cells. 



Kidney Dialysis: A new hospital kidney di- 
alysis center opened to serve local and re- 
gional needs of patients. 

Interferon: First successful trial by Stanford's 
Thomas Merigan and British scientists pre- 
vented common cold infections in human 
volunteers. This stimulated further research 
based on the belief that interferon, a natural 
protein produced by the body, could have fu- 
ture usefulness as an antiviral remedy if it 
could be mass produced. 

Heart Disease Prevention: Supported by a 
$4-million NIH grant, Stanford launched a 
new program to combat heart disease 
through education, including use of mass 



XVI 



and problem solving activities. This suggested "intelli- 
gent" computer programs, which employed a chain of 
reasoning analogous to human deduction and led him 
to join forces with Stanford computer scientists to ex- 
plore this application. Lederberg's efforts led to the 
installation of SUMEX-AIM (Stanford University Medi- 
cal Experimental Computer/Artificial Intelligence in 
Medicine) to provide the hardware for projects con- 
ducted by scientists nationwide. 

Lederberg's influence has extended beyond the con- 
fines of the campus. He once wrote a widely syndicated 
column for the Washington Post. He participated in ne- 
gotiations of the biological weapons disarmament treaty 
and fought for increasing public involvement in science 
policy. An article has summed up Lederberg "as the 
successful juxtaposition of scientist and humanist." 

HALSTED HOLMAN, M.D. 

Holman, chairman of medicine from 1960 to 1971, 
established a department with a strong biomedical re- 
search base. This, he explains, was in keeping with the 
then widely accepted notion that medical problems could 
be solved through research alone. Today he questions 
this idea not as inappropriate but as insufficient to deal 
with the problems of patients. "Biomedical research 
employs a reductionist method which studies phenom- 
ena in total isolation from surrounding intervening fac- 
tors," he says. "Yet the sick human being consists of 
interacting variables which determine direction, out- 
come and response of his illness to therapy." 

Nevertheless, the department under Holman's lead- 
ership did achieve important objectives. They included 
the development of a patient base in Palo Alto, which 
did not exist previously. Most significantly, they in- 
volved Holman's choice of young faculty who became 
leaders in research — Hugh McDevitt in immunology, 
Thomas Merigan in infectious disease, Stanley Cohen 
in clinical pharmacology and molecular genetics, Stan- 
ley Schrier in hematology and Donald Harrison in 
cardiology. 

As for the future, Holman, who now directs the Stan- 
ford Arthritis Center, thinks the department can and 
must develop new strengths. "This should not be undis- 
ciplined clinical development at the expense of science, 
but as a complement to it," he says, adding that the 




Korn 



stage for achieving that was set during Kenneth Mel- 
mon's chairmanship. 

DAVID KORN, M.D. 

Under Korn the department of pathology has achieved 
distinction for its double-pronged approach: the study 
of disease and the processes involved at the basic level. 
Korn, who came to Stanford from the National Insti- 
tutes of Health in 1968, recruited top talent — Ronald 
Dorfman, Richard Kempson and Howard Sussman in 
clinical services and laboratories. He appointed a host 
of basic scientists: Irving Weissman, Carl Grumet, Ed- 
gar Engleman, David Clayton, Errol Friedberg and oth- 
ers to work in hot areas of research with strong cellular 
and molecular focuses. Korn's own research is on en- 
zymes that synthesize DNA and are presumably in- 
volved in DNA replication in higher organisms. As 
biology became the cornerstone of medicine, Korn says, 
it was essential for pathology to remain responsible to 
the patient for services that depend on the pathologist's 
expertise. 



media, in three California communities. The 
program, a joint effort of the departments of 
medicine and communication and directed 
by John Farquhar and Henry Breitrose, was 
designed to stress changes in high risk hab- 
its. Closely tied in are the Lipid Research 
Clinic and Specialized Center for Research, 
which conduct studies on metabolic factors — 
fats, cholesterol and other compounds — that 
are risk factors in heart disease. 

Anesthetic Pollution: Female nurses and an- 
esthetists faced possible health risks because 
hospital operating rooms were contaminated 
by trace amounts of anesthetics, found Ellis 
Cohen, Weldon Bellville and Byron Brown. 



They showed anesthetic pollution to be asso- 
ciated with a high rate of spontaneous mis- 
carriages. They did not prove a cause-effect 
relationship, but anesthesiologist Charles 
Whitcher developed "a scavenging system" 
to vent gases out of operating rooms. Federal 
safety guidelines requiring such systems 
were adopted for hospitals nationwide. 

Arthritis Center: Stanford's Arthritis Center 
opened. Directed by Halsted Holman, it is 
part of a national network of 18 centers estab- 
lished by Congress to combat arthritis 
through research and emphasis on commu- 
nity-based educational programs. Closely 



linked is the American Rheumatism Associa- 
tion Medical Information System (ARAMIS), 
also federally funded and based at Stanford. 
Directed by James Fries, ARAMIS is the most 
comprehensive national data bank system on 
arthritis and related diseases ever devised. 

Vaccines: Human cell cultures developed 
and stored in the laboratory of microbiology 
professor Leonard Hayflick were licensed by 
NIH's Division of Biologies Standards to be 
used as a growth medium to make vaccines. 
Use of the human cells meant cheaper vac- 
cines, unmatched safety, and an end to the 
slaughter of monkeys whose cells had been 
widely used but could be contaminated by 
viruses. 



XVII 




MOMENTS 





■ 1 


' em 


*"' * 


■Hi 


v * r* ^ 


■ mi. Jr * 


Wfc 





1. Remember when the medical center's dedication got rained out, or 
rather, in? A publicity genius got a couple of duck decoys to float in 
a puddle for news pictures of the rows of sodden chairs. Quipped 
San Francisco Chronicle's Herb Caen, "Can you think of a better 
place to have your hunting accident?" 

2. Protest rallies against the Vietnam War were a familiar scene on the 
premises of the medical center in the '60s. 



3. The demolition of the old school on Clay and Webster streets in 
San Francisco in 1973 was observed by the revival of the popular 
revue "The Clay Street Blues," performed by professors and for- 
mer students. 

4. Nobel prize winning biochemist Arthur Kornberg (right) and col- 
league Mehran Goulian share a moment of triumph at a 1967 press 
conference to discuss synthesis of the first biologically active DNA. 

5. Volunteer and patient: reassuring moment. 



25 



YEARS" 



Crib-o-gram: An automated monitor that 
screens newborns for deafness was tested 
successfully in more than 6,000 babies at 
Stanford hospital nurseries over a two-year 
period. Early detected hearing loss could pre- 
vent retarded speech and language develop- 
ment. Invented by otolaryngologist Blair 
Simmons, the crib-o-gram is now used in 
many hospitals. 

New Concept: The first hospital-based Pso- 
riasis Day Care Center, directed and staffed 
by the department of dermatology, was 
opened at Hoover Pavillion. 



Centralization: Vice president and dean 
Clayton Rich announced consolidation of fis- 
cal and some administrative functions of the 
hospital, school and clinics under a single Of- 
fice of Medical Center Finance. Operational 
divisions between the hospital and the rest of 
the center set during joint ownership no 
longer made sense, he said. 

Genetic Engineering: Techniques developed 
by genetics professor Stanley Cohen and An- 
nie Chang at Stanford and Herbert Boyer at 
the University of California, San Francisco, 



demonstrated a practical method for trans- 
planting genes from one species to another. 
Their landmark contribution enabled studies 
of gene organization at a new level, and 
sparked development of the biotechnology 
industry. 

Opioid Receptor: A "narcotic receptor" gov- 
erning drug addiction was isolated by Avram 
Goldstein and colleagues in the pharmacol- 
ogy department and Addiction Research 
Foundation. 

Cancer Biology: The $1 .2-million Louis B. 
Mayer Cancer Biology Building to house re- 
search in basic immunology and virology 
was dedicated. 



XVUI 




6. All smiles after lengthy negotiations, vice president and medical 
school dean Robert J. Glaser, Stanford president J. Wallace Sterling 
and Palo Alto mayor Frances Dias, sign the agreement transferring 
ownership of the city's hospital wing to Stanford. 

7. The historic first adult heart transplant to be performed in the U.S., 
in Jan. 1968, was captured in the last frame of a surgical resident's 
film. Drs. Norman Shumway, Edward Stinson and Denver Nelson, 
and nurse Bernadine Hartman are shown at work. 



One head of state to visit the new medical center in 1960 was 
President Charles de Gaulle of France, seen here talking to a young 
patient and his mother. 

Gombe West, now defunct, was a chimpanzee colony established 
in 1970 near Jasper Ridge on campus to study hormones and 
behavior. Its inhabitants are shown in a typical grooming session. 



Inside Nerve Cells: The first successful re- 
cordings of electrical signals from inside neu- 
rons were achieved by neurologist David 
Prince and colleagues, allowing a closer look 
into brain diseases. 

Oncology Day Care: The Debbie Probst On- 
cology Day Care Center opened, more than 
doubling the center's cancer clinic facilities. 

Troubled Wing: The Phase I addition to the 
hospital opened after delays and cost-over- 
runs for correction of code deficiencies found 
by state and federal inspectors. The project 
added 25 intensive care beds and increased 
facilities for emergency services, X ray, sur- 
gical pathology, cardiology and postanes- 
thesia recovery. 



New Science Building: The $9.7-million 
Sherman Fairchild Center, with its 384-seat 
auditorium, was dedicated. The new struc- 
ture was built to house an expanded microbi- 
ology department and new departments of 
neurobiology and cell biology. 

More Marvels: A computer-based system to 
help physicians select anti-microbial therapy 
was developed by Edward Shortliff and col- 
leagues using hardware of SUMEX-AIM 
(Stanford University Medical Experimental 
Computer/Artificial Intelligence in 
Medicine). 



Paramedics: Stanford hospital became the re- 
gional center for paramedic training, which it 
had been doing since 1972. 

Opioids: Dynorphin, a brain chemical 200 
times more powerful than morphine, was 
discovered by pharmacology professor 
Avram Goldstein. 

Changes: Vice president for medical affairs 
and dean Clayton Rich resigned to "provide 
the school with the opportunity for new lead- 
ership." Rich made significant progress from 
1971 through 1978, particularly in the devel- 
opment of several basic science departments 
and recruitment of new faculty. But outside 
fiscal pressures had caused divisions and dif- 



XIX 



FAREWELL 



Lowell A. Rantz, M.D., 52. As head of the division of infectious 
diseases, he studied relationships between streptococcal infection and 
rheumatic fever. He helped disseminate and apply this knowledge to 
prevention efforts sponsored by the American Heart Association. The 
control of antibiotic resistant organisms and the relation of infection 
to polynephritis were topics he studied before his untimely death. 

1964 



Prize. He contributed techniques to the treatment of "blue babies" 
and was the first to perform the operation on the West Coast. In the 
30s he conceived the idea of grafting skin. His observations on the 
rejection phenomenon lay dormant for a quarter century, but they 
were so important he was honored for his contibutions by the 1972 
Congress of the Transplantation Society. 

1977 



Blake Wilbur, M.D., 72. He was a founder of the Palo Alto Medical 
Clinic and a son of Ray Lyman Wilbur, Stanford's president from 
1916 to 1943. He was a member of the clinical faculty and his students 
were interns and residents. A community leader, he was honored for 
his contributions when a university committee recommended that 
Blake Wilbur Drive, the road between Pasteur and Quarry Road near 
the medical center, be named in his honor. 

1973 

Judith Graham Pool, Ph.D. , 56. A physiologist, she revolutionized 
the care of the hemophilic patient when she found that the clotting 
factor could be extracted from normal donor plasma and administered 
to hemophilia patients who lacked the protein. That major achieve- 
ment today allows hemophiliacs to live nearly normal lives by treating 
themselves at home with injections. Gentle, unassertive, she was an 
inspired leader for her colleagues and students. By sheer force and 
will in the last years of her life, she worked to improve the role of 
women in science. 

1975 

Emile Frederic Holman, M.D., 87. "Master surgeon, brilliant 
scholar, devoted teacher" was how his contemporaries described him. 
Holman headed Stanford's surgical department from 1925 to 1955 
when the school was in San Francisco. His best known published 
research, "Arteriovenous Aneurysm: Abnormal Communications 
between the Arterial and Venous Circulations," won him the Gross 




Pool 



25 



YEARS" 



ferences within the school. Deputy dean and 
hospital chief of staff Lawrence Crowley be- 
came vice president for medical affairs. 

THE EIGHTIES 

Decentralization: Crowley restructured the 
medical center's administrative organization, 
with the hospital becoming a subsidiary 
managed by a board appointed by university 
trustees as general corporate members. The 
university clinics were separated from the 
hospital and the faculty medical practice be- 
came self-governing. 



Health Policy: A consortium involving nine 
research programs dealing with national 
health policy was created, chaired by John 
Bunker, director of health services research. 
The members are experts in economics, legis- 
lative reform, technology assessment and or- 
ganization and health care delivery. 

Triumvirate: Sheldon King of UC Hospital, 
San Diego, became associate vice president 
and director of Stanford University Hospital, 
succeeding Peter Levin. Donald Tower, direc- 
tor of a group medical practice in Columbia, 
Mo., was appointed director of Stanford Uni- 
versity Clinic, and Dominick Purpura, noted 
neuroscientist from Albert Einstein College 
of Medicine, became dean. 



Minorities: A 1981 report from the Office of 
Statewide Health Planning in Sacramento 
singled out Stanford University School of 
Medicine as "the model" of how to attract 
and enroll minority medical students. Stan- 
ford's figures showed a minority enrollment 
of 26.7 percent in the entering class, the top 
in the state. However, a faculty report re- 
leased at the same time indicated Stanford 
medical school had not made much progress 
in recruitment of minority faculty, and 
changing the situation was a top priority. 

Hodgkin's Disease: Twenty years of Stanford 
treatment trials for Hodgkin's disease were 



XX 




Eloesser 

Gordon Gould, Ph.D., 68. Modern treatment for high cholesterol 
and atherosclerosis owes a great debt to Gould's work. Most of his 20- 
year career at Stanford was spent helping to unravel the complex 
sequence by which the liver manufactures and breaks down choles- 
terol, regulating its level in the blood. An organic chemist, he directed 
the clinical chemistry laboratory at Stanford University Hospital, in 
addition to being an ardent conservationist on the Stanford campus. 

1978 

Leo Eloesser, M.D., 95. He was a brilliant thoracic surgeon, world 
traveler and adventurer. He gained fame for his humanitarian mis- 
sions to Russia, South America and China before World War II. He 



was an accomplished violinist and writer, and operated Loyalist field 
hospitals during the Spanish Civil War. Retired in 1964, Eloesser had 
built a reputation as an eccentric who often spent long nights sailing 
San Francisco Bay in his 32-foot sloop, accompanied by his dog and 
playing the violin. 

1976 

Harold Kniest Faber, M.D., 94. His contributions to pediatrics at 
Stanford and, in a broader sense, to world pediatrics, were without 
equal. Known for his polio research, Faber founded Children's Hos- 
pital at Stanford and headed the pediatrics department for 26 years 
prior to retiring in 1949. 

1979 

Russel Van Arsdale Lee, M.D., 87. He founded the Palo Alto 
Medical Clinic and pioneered in the development of group practice 
when it was controversial and an anathema to organized medicine. 
The physician and friend of a succession of Stanford presidents, he 
supported the school's move from San Francisco to the campus and 
led the drive to construct the Palo Alto-Stanford Hospital Center as a 
joint university-city of Palo Alto venture. He worked with the Tru- 
man Commission which developed recommendations for prepaid na- 
tional health insurance and other health legislation. His interest in 
senior citizens led to the founding of Channing House, but most 
important, Lee was known as a man who devoted most of his time to 
his patients. 

1982 

Loren "Yank" Chandler, M.D., 88. Defying the average term for 
deans of five years, Chandler served in the post for 20 years when 
Stanford medical school was in San Francisco. He saw the school 
through the Depression and World War II, and handed diplomas to 
21 classes of physicians. When he resigned because of his opposition 
in 1953 to the school's relocation, he was praised for his notable 
contributions that lent "distinction to Stanford's place in medicine." 
An advocate of prepaid medical care, Chandler was instrumental in 
developing the California Physicians Service and Blue Cross. He had 
served as president of the Association of American Medical Colleges, 
and on the AMA commission which studied the British National 
Health Service in 1950. He concluded it would be "folly" to institute 
such a plan in the U.S. After the school's relocation, Chandler served 
as chief of surgery at the Palo Alto Veterans Administration Medical 
Center, of which he was a key planner. 

1982 



celebrated on campus by more than 800 ex- 
patients. In noother malignancy have gains 
been more dramatic, with 85 percent of pa- 
tients surviving seven years after diagnosis 
of the cancer, and 75 percent permanently 
cured. In children, survival rates soar to 96 
percent alive after 11 years past diagnosis, 
with 93 percent of children never experienc- 
ing a relapse. 

Heart-Lungs: The first successful human 
combined heart-lung transplant in the world 
(fourth attempt) was performed by Bruce 
Reitz, Shumway and colleagues. 



Cancer weapons: The first successful use of 
man-made monoclonal antibodies to treat 
cancer was reported by oncologist Ronald 
Levy. 

Elusive Gene: A key immune gene, sought 
unsuccessfully for a decade by researchers 
around the world, was isolated by microbiol- 
ogist Mark Davis in collaboration with UC 
San Diego's Stephen Hedrick and NIH re- 
searchers. Gene in hand, scientists believe 
they can begin to unravel immunity's secrets. 

Biclonal Cancer: Jeffrey Sklar and colleagues 
discovered tumors with two single-cell ances- 
tors in patients with B-cell lymphoma. Tu- 
mors, it was thought, began in a single cell 



that mutated and replicated, producing iden- 
tical copies. Sklar's discovery has future im- 
plications as scientists develop tailor-made 
anticancer agents called monoclonal antibod- 
ies to attack specific cells. 

Magnetic Resonance: A new center is 
planned by the school and hospital to explore 
diagnostic and research applications of nu- 
clear magnetic resonance, co-invented by 
Stanford Nobel laureate Felix Bloch. It pro- 
duces computer-generated images of cross 



XXI 



George A. Feigen, Ph.D., 66. He was known for research on the 
immune response. He studied anaphylactic shock — the most severe 
allergic response — and its effects on heart and blood vessels. An 
individual of diverse interests and accomplishments, he became a 
knowledgeable marine biologist. To illustrate his never-flagging curi- 
osity about biological phenomena, his friends said of him: "Whenever 
George Feigen came across an unfamiliar marine creature in some 
tidal pool, his first impulse was to make an antibody to it." Most 
important, Feigen was known as a teacher who commanded respect 
and demanded the highest standards. 

1983 





Feigen 



Kaplan 

Henry Seymour Kaplan, M.D., 65. A colossal figure who domi- 
nated the field of cancer research and councils of the Stanford medical 
school for more than a quarter century. As professor and chairman of 
radiology, he changed Hodgkin's disease from a hopeless illness to one 
that is more than 90 percent curable when treated early. His science 
was devoted to understanding the cause of the lymphomas, ultimately 
discovering the radiation leukemia virus in the mouse, a contribution 
to what is now appreciated as oncogene research. His search for a 
potent anticancer weapon was realized in the first medical linear 
accelerator to be constructed in the Western Hemisphere, proposed by 
Kaplan and executed by physicist Edward Ginzton at Stanford. 
Kaplan was a chief architect in the transformation of Stanford Uni- 
versity School of Medicine into one of the nation's leading medical 
centers. 

1984 



25 



YEARS" 



sections of the body or a single organ, and 
can deliver chemical as well as physical 
information. 

Merger: Stanford hospital and Children's 
Hospital at Stanford (CHAS) agreed to con- 
solidate at a site adjacent to the medical cen- 
ter. The new CHAS, estimated to cost $40 
million, is being designed by the San Fran- 
cisco firm of Anshen and Allen. Pediatric 
chairman Irving Schulman and faculty are 
planning new academic programs to 
strengthen the venture. 



Another Casualty: The medical school an- 
nounced it will terminate its training pro- 
gram in physical therapy after graduation of 
the present class. The reason: fiscal con- 
straints and changing priorities. 

Falk Center: The $14-million Dr. Ralph and 
Marian Falk Cardiovascular Research Center 
was dedicated, funded entirely by private 
gifts in which Friends of Cardiovascular Sur- 
gery played a key role. 

Molecular and Genetic Medicine: A $45-mil- 
lion center planned to focus on studies of dis- 
ease at the molecular level will house 35 fac- 
ulty members and include space leased by 
the Miami-based Howard Hughes Medical 



Research Institute for as many as eight fac- 
ulty supported by Hughes. 

Transition: Dean Dominick Purpura resigned 
to become dean at Albert Einstein College of 
Medicine, whose neuroscience programs he 
formerly headed. 

Modernization: The first phase of Stanford 
University Hospital's $110-million moderni- 
zation began in July, 1984. Initial construction 
will complete shelled space in the first wing 
addition to the hospital which opened in 
1977. 



XXII 



VOICES 



"The university medical center is inevitably a key com- 
munity resource; it is a referral center with unique 
programs that complement those of the community at 
large. It is the locus for pilot programs directed to- 
ward the demonstration of better ways to administer 
health care to our fellow citizens. But if and when the 
university medical center gets so involved in service 
loads that these become an end in themselves, efforts 
in education and research will suffer." 

Robert J. Glaser,M.D. 
Former Dean 

"Medical schools . . . are, like most institutions, social 
instruments which had better reflect and express soci- 
ety's needs or they will languish for public support, 
possibly perish, or worst of all, become objects of ridi- 
cule and distrust." 

William P. Creger, M.D. 
Professor of Medicine 

"Medical molecules are even more valuable fruits 
of biomedical investigation than are elegant medical 
machines like the artificial kidney." 

Joshua Lederberg. Ph.D. 

Nobel Laureate, Former Chairman 

and Genetics Professor 

"I am afraid of anything that is politically controlled. I 
don't even like municipally owned railroads or street 
cars — they cost too much money." 

Loren "Yank" Chandler, M.D. 
Former Dean 

"At its finest, the medical profession can and should 
liberate one to apply his or her scientific talents 
together with human concern." 

Robert A. Chase, M.D. 
Professor of Surgery 

"We must have affirmative action programs for schol- 
arship. Otherwise medicine will revert to empiricism, 
which means it will be approaching witchcraft once 
again." 

Arthur Kornberg, M.D. 

Nobel Laureate and Professor of 

Biochemistry 

"Stanford in its educational philosophy has placed 
great importance in the development of physicians 
who will have an analytical approach toward medi- 
cine — whether they choose to become academicians 
or practitioners." 

Clayton Rich, M.D. 
Former Dean 



"I detect an increasing trend of concern on the part of 
medical students with learning more about how pa- 
tients are taken care of in the milieu of their everyday 
lives." 

ErlingW.Fredell,M.D. 
Clinical Associate Professor of 
Medicine 

"We have tried to do all things for medical and social 
problems over which we have no control and which 
are not the function of a university medical school. 
The problems related to Medi-Cal and Medicare and 
their destructive effects on the financing of the medi- 
cal school are a contemporary disaster. Should we not 
have refused to accept these responsibilities?" 

Roy Cohn, M.D. 

Professor of Surgery Emeritus 

"In a sense the federal government is directly responsi- 
ble for the high level of progress in heart transplanta- 
tion which today it feels constrained to evaluate with 
respect to ethical, social, legal, economic and political 
implications." 

Norman E. Shumway, M.D. 
Professor of Cardiovascular Surgery 

"President Nixon and the entire Congress have de- 
clared that cancer will be cured. . . .Unfortunately, no 
firm (scientific) base for the development of a cen- 
trally directed cancer program currently exists. The 
net result to cure cancer may well be to slow down 
rather than speed up progress." 

Leonard Herzenberg, Ph.D. 
Professor of Genetics 

'I've always been a great house-call man. The only real 
participation a doctor gets is when he sits on the side 
of the bed and boils his hypos in the bathroom and 
that sort of thing. It's the most rewarding of human 
experiences." 

RusselV. Lee, M.D. 

Clinical Professor of Medicine 

and Founder, Palo Alto Medical 

Clinic 

"I believe it is a mark of disrespect to both the patient 
and the physician for students to dress inappro- 
priately, to smoke in their presence, to eat or drink 
food during the presentation, to read the newspaper, 
or to otherwise display unprofessional behavior." 

Joseph P. Kriss, M.D. 

Professor of Medicine and Radiology 



XXIII 




This sculpture honoring Dr. Henry Kaplan is situated in front of the medical 
center. The artist, renowned Cubist Jacques Lipchitz, called it "Song of the 
Vowels." He created it, he once said, to attempt to suggest the power of man 
over nature. 

Kaplan, internationally known for his work in radiology and cancer re- 
search, said shortly before his death that he thought one of his greatest 
accomplishments was helping to develop a treatment program to overcome 
Hodgkin's disease, formerly a fatal cancer. 

The sculpture depicts the theme of twin harpists, and art critics say it 
celebrates Lipchitz' optimism about humanity's power to triumph over adver- 
sities encountered in nature. 

Kaplan had expressed his admiration for and ability to identify with 
Lipchitz' work. 



Stanford University 

Office of Public Events 

Stanford University Medical Center 

750 Welch Road, Suite 300 

Palo Alto, California 94304